In the hilly and mountainous area of Manebhanjyang in Nepal, a local youth group has been dedicating their spare time to spreading awareness of the neglected tropical diseases (NTDs) that are affecting their communities.

With the closure of many of their normal activities due to the COVID-19 outbreak, Sabin, Tara, Bishwa, Prakash and Manoj have channelled the extra time they have had into a series of awareness activities to educate residents on NTDs, such as visceral leishmaniasis and lymphatic filariasis, which are common in this part of the world.

Sitting with a crowd outside Atithi Bhojanalaya, a local hotel, Bishwa shares a story of a Nepalese lady who was bitten by a mosquito carrying lymphatic filariasis. Bishwa describes the disease made the lady’s leg swell to the point where she could no longer walk. Unable to work and stigmatised for having a disability, the woman’s life spiralled into a state of poverty. And yet, Bishwa explains to those listening, there are preventative measures that can help control and even eliminate NTDs in the area.

This is a fictionalised scenario that unfolds as part of a Nepalese radio drama that has recently been broadcast to over 753 municipalities. The context behind the story is, however, unfortunately very close to reality.

One quarter of Nepal’s 27 million population lives below the poverty line. Often residing in hard to reach areas with limited access to nearby health facilities, this segment of the population is most at risk of contracting endemic NTDs.

Nepal is committed to preventing these diseases and has already made major strides towards achieving this goal. In 2018, it became the first country in Southeast Asia to eliminate trachoma as a public health problem. As Nepal continues its progress, the UKAid-funded Accelerating the Sustainable Control and Elimination of NTDs (Ascend) Lot 1 programme is working alongside the government to strengthen the capacity of health systems, as well as its drug supply chains. The programme has a strong focus on strengthening existing systems to ensure solutions are durable and sustainable. After all, some of these diseases have been around since the Egyptian pharaohs – so it’s about time they were eliminated for good.

Throughout the COVID-19 outbreak, Ascend Lot 1 has been quick to adapt NTD programming, providing risk assessments and guidance on how NTD interventions can restart safely during the pandemic. New tactics have been deployed, such as screening for NTDs at the same time as testing for the COVID-19 virus in quarantine centres.

The new radio drama series has been the most unique NTD intervention. Initially planned as a series of street dramas, following the outbreak of the pandemic, the performances have been converted into a radio show to communicate awareness of NTDs through the stories of Sabin, Tara, Bishwa, Prakash and Manoj. With a total of 36 episodes playing on a weekly basis across 20 national radio stations the messages are reaching approximately ten million people.

To date, the radio show has proved effective as an education tool and in changing behaviours, particularly in its far-reaching accessibility to hard-to-reach areas that otherwise might get left behind. Each episode is translated into ten local languages to ensure the widest reach possible.

By using storytelling as a mechanism to convey public health concerns, the messages both entertain and inform, resonating with a wider range of listeners than conventional methods. The show also spreads awareness amongst the 32% of the population that have low levels of literacy and would otherwise be omitted from written forms of communication.

At the end of each episode, listeners to the show are provided with dial-in numbers to call if they require further information on NTDs, COVID-19 or other health advice. An automated interactive voice response (IVR) shares this information in a choice of different local languages. The aim is to encourage further action to prevent and treat NTDs, including follow-up visits to health centres. Demographic data is also collected from callers to help the Ascend team more accurately map those suffering from NTDs across the country.

With 36 episodes planned to run into 2021, Ascend will continue to share stories of the youth group through its mass radio campaign as part of wider work with the Nepalese government to eliminate NTDs. By ensuring the Nepalese population are well-informed about the diseases, more can be done to prevent them ever being contracted – taking the ‘neglected’ out of neglected tropical diseases in Nepal.

Story by Laura McLean, Crown Agents Ascend Lot 1